COVID-19 Digital Health Innovation Policy: A Portal to Alternative Futures in the Making

Short- and Long-Term Predicted and Witnessed Consequences of Digital Surveillance During the COVID-19 Pandemic: Scoping Review

BACKGROUND

The COVID-19 pandemic has prompted the deployment of digital technologies for public health surveillance globally. The rapid development and use of these technologies have curtailed opportunities to fully consider their potential impacts (eg, for human rights, civil liberties, privacy, and marginalization of vulnerable groups).

OBJECTIVE

We conducted a scoping review of peer-reviewed and gray literature to identify the types and applications of digital technologies used for surveillance during the COVID-19 pandemic and the predicted and witnessed consequences of digital surveillance.

METHODS

Our methodology was informed by the 5-stage methodological framework to guide scoping reviews: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarizing, and reporting the findings. We conducted a search of peer-reviewed and gray literature published between December 1, 2019, and December 31, 2020. We focused on the first year of the pandemic to provide a snapshot of the questions, concerns, findings, and discussions emerging from peer-reviewed and gray literature during this pivotal first year of the pandemic. Our review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting guidelines.

RESULTS

We reviewed a total of 147 peer-reviewed and 79 gray literature publications. Based on our analysis of these publications, we identified a total of 90 countries and regions where digital technologies were used for public health surveillance during the COVID-19 pandemic. Some of the most frequently used technologies included mobile phone apps, location-tracking technologies, drones, temperature-scanning technologies, and wearable devices. We also found that the literature raised concerns regarding the implications of digital surveillance in relation to data security and privacy, function creep and mission creep, private sector involvement in surveillance, human rights, civil liberties, and impacts on marginalized groups. Finally, we identified recommendations for ethical digital technology design and use, including proportionality, transparency, purpose limitation, protecting privacy and security, and accountability.

CONCLUSIONS

A wide range of digital technologies was used worldwide to support public health surveillance during the COVID-19 pandemic. The findings of our analysis highlight the importance of considering short- and long-term consequences of digital surveillance not only during the COVID-19 pandemic but also for future public health crises. These findings also demonstrate the ways in which digital surveillance has rendered visible the shifting and blurred boundaries between public health surveillance and other forms of surveillance, particularly given the ubiquitous nature of digital surveillance.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-https://doi.org/10.1136/bmjopen-2021-053962.

Telehealth Actions to Address COVID-19 in Latin American Countries

Introduction: This study set out to examine the use of telehealth resources to tackle the coronavirus disease 2019 (COVID-19) pandemic in Latin America within the scope of national telehealth projects (NTPs). Methods: A qualitative study developed using ethnomethodology for appropriate understanding of how telehealth actions were carried out in practice during the COVID-19 pandemic within the scope of NTPs, in the following countries: Argentina, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Peru, and Uruguay. The study was carried out from October to 2020 to March 2021. The number of participations in the discussion groups, formed by coordinating teams of NTPs, totaled 90. Results were described in the worksheet completed according to the script. Each country reviewed its respective data, three times on average, in an effort to clarify actions developed. Results: Three groups of countries were identified: (1) Countries with a telehealth background that used these resources to tackle COVID-19 and thereby refined telehealth activities. Countries with greater experience in NTP design, such as Mexico, Colombia, Peru, and Argentina, were able to use a wide range of telehealth activities to tackle the pandemic, with offers of teleconsultation, teleguidance, telemonitoring to patients, and training of health professionals; (2) Countries with some telehealth activities to address COVID-19. Uruguay, Ecuador, El Salvador, and Costa Rica; and (3) Countries with no evidence of telehealth resource use during the pandemic. Honduras and Guatemala. Discussion: Most NTPs in Latin America have improved their telehealth activities, contributing to address the COVID-19 pandemic in Latin America.

Use of digital technologies for public health surveillance during the COVID-19 pandemic: A scoping review

Throughout the COVID-19 pandemic, a variety of digital technologies have been leveraged for public health surveillance worldwide. However, concerns remain around the rapid development and deployment of digital technologies, how these technologies have been used, and their efficacy in supporting public health goals. Following the five-stage scoping review framework, we conducted a scoping review of the peer-reviewed and grey literature to identify the types and nature of digital technologies used for surveillance during the COVID-19 pandemic and the success of these measures. We conducted a search of the peer-reviewed and grey literature published between 1 December 2019 and 31 December 2020 to provide a snapshot of questions, concerns, discussions, and findings emerging at this pivotal time. A total of 147 peer-reviewed and 79 grey literature publications reporting on digital technology use for surveillance across 90 countries and regions were retained for analysis. The most frequently used technologies included mobile phone devices and applications, location tracking technologies, drones, temperature scanning technologies, and wearable devices. The utility of digital technologies for public health surveillance was impacted by factors including uptake of digital technologies across targeted populations, technological capacity and errors, scope, validity and accuracy of data, guiding legal frameworks, and infrastructure to support technology use. Our findings raise important questions around the value of digital surveillance for public health and how to ensure successful use of technologies while mitigating potential harms not only in the context of the COVID-19 pandemic, but also during other infectious disease outbreaks, epidemics, and pandemics.

Equitable Design and Use of Digital Surveillance Technologies During COVID-19: Norms and Concerns

Given the unprecedented scale of digital surveillance in the COVID-19 pandemic, designing and implementing digital technologies in ways that are equitable is critical now and in future epidemics and pandemics. Yet to date there has been very limited consideration about what is necessary to promote their equitable design and implementation. In this study, literature relating to the use of digital surveillance technologies during epidemics and pandemics was collected and thematically analyzed for ethical norms and concerns related to equity and social justice. Eleven norms are reported, including procedural fairness and inclusive approaches to design and implementation, designing to rectify or avoid exacerbating inequities, and fair access. Identified concerns relate to digital divides, stigma and discrimination, disparate risk of harm, and unfair design processes. We conclude by considering what dimensions of social justice the norms promote and whether identified concerns can be addressed by building the identified norms into technology design and implementation practice.

Handling COVID-19 in the capital city of Jakarta with innovation policy: the scale of social restrictions policy

This study aimed to examine the dominant innovation policy elements of the social restrictions to fight the COVID-19 pandemic in Jakarta. The data was obtained using a Computer-Aided Qualitative Data Analysis Software named the NVivo 12 Plus application, accompanied by purposive sampling from four online media sources. These sites, namely Detik.com, Kompas.com, Liputan6.com, and Kumparan.com, were accessed for their provision of information about the COVID-19 social restriction policy in DKI Jakarta. Subsequently, the results showed that the Jakarta government's decision on the Large-Scale Social Restriction-PSBB Stage 1-5 and PPKM Stage consider relative advantage and trialability aspects. Following the proposed policy design, the Jakarta Government expects an easier adoption of the innovation in slowing the spread of the virus. Relative advantage and trialability were revealed to enable developing countries to manage or control the number of pandemic cases and the ensuing economic impact, as well as innovate their policies in practical cases based on the field situation. This study only focused on Jakarta as one of the South East capital cities that successfully dealt with COVID-19. Therefore, future studies should obtain policy designs from other continents that successfully tackled the pandemic in different situations.

Health Literacy, Equity, and Communication in the COVID-19 Era of Misinformation: Emergence of Health Information Professionals in Infodemic Management

The health information management (HIM) field’s contribution to health care delivery is invaluable in a pandemic context where the need for accurate diagnoses will hasten responsive, evidence-based decision-making. The COVID-19 pandemic offers a unique opportunity to transform the practice of HIM and bring more awareness to the role that frontline workers play behind the scenes in safeguarding reliable, comprehensive, accurate, and timely health information. This transformation will support future research, utilization management, public health surveillance, and forecasting and enable key stakeholders to plan and ensure equitable health care resource allocation, especially for the most vulnerable populations. In this paper, we juxtapose critical health literacy, public policy, and HIM perspectives to understand the COVID-19 infodemic and new opportunities for HIM in infodemic management.

Evaluating the risk factor of novel public health disaster “Omicron” variant: an Indian prospective

COVID-19 epidemic is destroying world health and gradually increasing the mortality rate. The economy was also affected due to the spreading of the newly developed virus. The named COVID-19 progressively develops and affecting in the human body. The new Delta variant Omicron is first noticed in South Africa. After that many cases are recorded worldwide and finally India has recorded the first case of Omicron on 24 November 2021 from Karnataka. This study is to identify the Omicron variant affected states and UTs in India. The graphical results indicate the geographical location-wise spreading of the Omicron virus in India. The destibution of confirmed and death cases indicate the speed of spreading this health disaster in India. After that total of 781 cases were registered and 241 people were discharged from this. Mostly affected states and UTs are Delhi, Maharashtra, Karnataka, Telangana, Kerala, and Rajasthan, where Tripura, Bihar, Jharkhand, Assam, and Sikkim have not any Omicron recorded. Delhi (238), Maharashtra (167), Gujarat (73), and Kerala (65), where Himachal Pradesh, Goa, Manipur, and Ladakh have recorded one case each. The correlation between total cases and discharge is very high and the R2 value is strong positive (0.80). This situation is indicating that Omicron is gripped by public health. If we don’t maintain the social distancing and WHO notified guidelines, this condition may more harmful for human livelihood and increase the health emergency very soon.

Accelerating Digital Transformation Implementation in the Fight Against Corruption?

Our article is the first to empirically analyze the effects of digitalization on corruption prevalence by using a sample of 27 European countries over the period 2015-2020. We utilize the digital economy and society index capturing five diverse aspects of digital transformation: connectivity, human capital, use of the internet, integration of digital technology, and digital public services to reflect digital performance. We also consider influences of specific digital activities, such as online transactions, business digitization, e-Commerce, and e-Government. Our results indicate that digitalization, especially the use of internet services and digital public services reduced the prevalence of corruption in European countries. However, the effect of digital transformation only appears in the long run. Notably, we highlight the importance of online administrative procedures on combating corruption, especially during the Covid-19 pandemic.

Can Digital Transformation Promote the Rapid Recovery of Cities from the COVID-19 Epidemic? An Empirical Analysis from Chinese Cities

Background: Digital transformation has become a key intervention strategy for the global response to the COVID-19 epidemic, and digital technology is helping cities recover from the COVID-19 epidemic. However, the effects of urban digital transformation on the recovery from the COVID-19 epidemic still lack mechanism analyses and empirical testing. This study aimed to explain the theoretical mechanism of urban digital transformation on the recovery from the COVID-19 epidemic and to test its effectiveness using an empirical analysis. Methods: This study, using a theoretical and literature-based analysis, summarizes the impact mechanisms of urban digital transformation on the recovery of cities from the COVID-19 epidemic. A total of 83 large- and medium-sized cities from China are included in the empirical research sample, covering most major cities in China. The ordinary least squares (OLS) method is adopted to estimate the effect of China’s urban digitalization level on population attraction in the second quarter of 2020. Results: The theoretical analysis found that urban digital transformation improves the ability of cities to recover from the COVID-19 epidemic by promoting social communication, collaborative governance, and resilience. The main findings of the empirical analysis show that the digital level of a city has a significant positive effect on urban population attraction (p < 0.001). Conclusions: A positive relationship was found between urban digital transformation and the rapid recovery of cities from the COVID-19 epidemic. Digital inventions for social communication, collaborative governance, and urban resilience are an effective way of fighting the COVID-19 emergency.

Disinformation as COVID-19's Twin Pandemic: False Equivalences, Entrenched Epistemologies, and Causes-of-Causes

We are currently facing and traversing in the thick of a twin pandemic: coronavirus disease 2019 (COVID-19) and disinformation. Disinformation is false information created and spread deliberately with the intention to mislead public opinion, obscure truths, and undermine trust in knowledge. The digital age we live in is quite different than the printing revolution and invention of the oil-based ink printing press centuries ago. Digital technologies can spread and repeat disinformation at extremely high speeds, while anyone, a qualified expert or not, and with internet access, can become an author. To fight disinformation, we ought to dismantle the entrenched and extractive epistemologies that act as upstream drivers and sites of disinformation production. Epistemology refers to the value-laden knowledge frames, overarching master narratives, and storylines, in which knowledge is produced. If the epistemologies in which we generate knowledge are false, then the knowledge products will be laden with disinformation. Moreover, the harms caused by disinformation can extend well beyond the immediate knowledge domain where disinformation has originated. This occurs when "false equivalence" is used as a form of rhetoric. False equivalence is a type of flawed sense making where equal weight is given to arguments with concrete material evidence, and those that are conjecture, untrue, or unjust. This article presents an analysis of the disinformation pandemic attendant to COVID-19, with an eye to its causes-of-causes: unchecked extractive epistemologies (e.g., technocracy), and the practice of false equivalence in pandemic discourses. We argue that holding the political agency of master narratives to account is essential (1) to fight the disinformation pandemic and (2) for prefigurative politics to build egalitarian and democratic societies in place of the instrumental/transactional relationships that typify the contemporary nation states and the neoliberal university whose ossified rituals lack the normative capacities for critical governance in a time of converging social, digital, and ecological crises. For liberation from disinformation, we should start with liberation from entrenched extractive epistemologies in science and society.

Identifying and addressing digital health risks associated with emergency pandemic response: Problem identification, scoping review, and directions toward evidence-based evaluation

BACKGROUND AND OBJECTIVE

The COVID-19 pandemic has accelerated digital health applications in multifaceted disease management dimensions. This study aims (1) to identify risk issues relating to the rapid development and redeployment of COVID-19 related e-health systems, in primary care, and in the health ecosystems interacting with it and (2) to suggest evidence-based evaluation directions under emergency response.

METHOD

After initial brainstorming of digital health risks posed in this pandemic, a scoping review method was adopted to collect evidence across databases of PubMed, CINAHL, and EMBASE. Peer-review publications, reports, news sources, and websites that credibly identified the challenges relating digital health scaled for COVID-19 were scrutinized. Additional supporting materials were obtained through snowball sampling and the authors' global digital health networks. Studies satisfying the selection criteria were charted based on their study design, primary care focus, and coverage of e-health areas of risk.

RESULTS

Fifty-eight studies were mapped for qualitative synthesis. Five identified digital health risk areas associated with the pandemic were governance, system design and coordination, information access, service provision, and user (professional and public) reception. We observed that rapid digital health responses may embed challenges in health system thinking, the long-term development of digital health ecosystems, and interoperability of health IT infrastructure, with concomitant weaknesses in existing evaluation theories.

CONCLUSION

Through identifying digital health risks posed during the pandemic, this paper discussed potential directions for next-generation informatics evaluation development, to better prepare for the post-COVID-19 era, a new future epidemic, or other unforeseen global health emergencies. An updated evidence-based approach to health informatics is essential to gain public confidence in digital health across primary and other health sectors.

Keeping it going: the importance of delivering interprofessional education during the COVID-19 pandemic

BACKGROUND AND CONTEXT Globally, the coronavirus disease 2019 (COVID-19) pandemic has highlighted the need for better interprofessional collaboration and teamwork. When disciplines have worked together to undertake testing, deliver care and administer vaccines, progress against COVID-19 has been made. Yet, teamwork has often not happened, wasting precious resources and stretching health-care workforces. Continuing to train health professionals during the pandemic is challenging, particularly delivering interprofessional education that often uses face-to-face delivery methods to optimise interactional learning. Yet, continuing to offer interprofessional education throughout the pandemic is critical to ensure a collaboration-ready health workforce. One example is continuing the established INVOLVE (Interprofessional Visits to Learn Interprofessional Values through Patient Experience) interprofessional education initiative. ASSESSMENT OF PROBLEM Educators have not always prioritised interprofessional education during the pandemic, despite its immediate and long-term benefits. The INVOLVE interprofessional education initiative, usually delivered face-to-face, was at risk of cancellation. RESULTS A quality improvement analysis of the strategies used to continue INVOLVE demonstrated that it is possible to deliver interprofessional education within the constraints of a pandemic by using innovative online and hybrid educational strategies. Educators and students demonstrated flexibility in responding to the sudden changes in teaching and learning modalities. STRATEGIES When pandemic alert levels change, interprofessional educators and administrators can now choose from a repertoire of teaching approaches. LESSONS Four key lessons have improved the performance and resilience of INVOLVE: hold the vision to continue interprofessional education; be nimble; use technology appropriately; and there will be silver linings and unexpected benefits to the changes.

Impact of the COVID-19 pandemic on ongoing health research: an ad hoc survey among investigators in Germany

OBJECTIVES

To gain insights into the impact of the COVID-19 pandemic on ongoing health research projects, using projects from a selected funding programme in Germany as an example.

DESIGN

Online survey and validation workshop.

SETTING

Lockdowns and social distancing policies impact on clinical and public health research in various forms, especially if unrelated to COVID-19. Research institutions have reduced onsite activities, data are often collected remotely, and during the height of the crisis, clinical researchers were partially forced to abandon their projects in favour of front-line care.

PARTICIPANTS SURVEY

120 investigators of health research projects across Germany, performed between 15 and 25 May 2020; workshop: 32 investigators, performed on 28 May 2020.

RESULTS

The response rate (78%) showed that the survey generated significant interest among investigators. 85 responses were included for analysis, and the majority of investigators (93%) reported that their projects were affected by the pandemic, with many (80%) stating that data collection was not possible as planned, and they could not carry out interventions as intended (67%). Other impacts were caused by staff being unavailable, for example, through child or elder care commitments or because of COVID-19 quarantine or illness. Investigators also reported that publications were delayed or not feasible at all (56%), and some experienced problems with PhD or Masters theses (18%). The majority of investigators had mitigation strategies in place such as adjustment of data collection methods using digital tools (46%) or of project implementation in general (46%), others made changes in research design or research questions (27%).

CONCLUSIONS

The COVID-19 pandemic has severely impacted on health research projects. The main challenge is now to mitigate negative effects and to improve long-term resilience in health research. The pandemic has also acted as a driver of innovation and change, for example, by accelerating the use of digital methods.

Rigorous Policy-Making Amid COVID-19 and Beyond: Literature Review and Critical Insights

Policies shape society. Public health policies are of particular importance, as they often dictate matters in life and death. Accumulating evidence indicates that good-intentioned COVID-19 policies, such as shelter-in-place measures, can often result in unintended consequences among vulnerable populations such as nursing home residents and domestic violence victims. Thus, to shed light on the issue, this study aimed to identify policy-making processes that have the potential of developing policies that could induce optimal desirable outcomes with limited to no unintended consequences amid the pandemic and beyond. Methods: A literature review was conducted in PubMed, PsycINFO, and Scopus to answer the research question. To better structure the review and the subsequent analysis, theoretical frameworks such as the social ecological model were adopted to guide the process. Results: The findings suggested that: (1) people-centered; (2) artificial intelligence (AI)-powered; (3) data-driven, and (4) supervision-enhanced policy-making processes could help society develop policies that have the potential to yield desirable outcomes with limited unintended consequences. To leverage these strategies' interconnectedness, the people-centered, AI-powered, data-driven, and supervision-enhanced (PADS) model of policy making was subsequently developed. Conclusions: The PADS model can develop policies that have the potential to induce optimal outcomes and limit or eliminate unintended consequences amid COVID-19 and beyond. Rather than serving as a definitive answer to problematic COVID-19 policy-making practices, the PADS model could be best understood as one of many promising frameworks that could bring the pandemic policy-making process more in line with the interests of societies at large; in other words, more cost-effectively, and consistently anti-COVID and pro-human.

Staying Active While Staying Home: The Use of Physical Activity Technologies During Life Disruptions

One impact of the Covid-19 lockdowns was a restriction on people's ability to engage in physical activity in previously routine ways. This paper presents a two-stage mixed-method study exploring how people used technology to stay physically active during this period. We found that activity trackers reminded people to be active, while virtual coaching (i.e., video tutorials and online classes) helped them stay connected. The lockdown increased people's awareness of their activity levels and removed barriers to exercise, for example by giving them greater control over their time. However, it also created new challenges, with lack of time and space, injuries due to sudden changes in activity, and anxiety around lockdown, putting limits on physical activity. We highlight future directions that must be addressed to maximise the benefits of physical activity technologies for people trying to stay active during major life disruptions.

Understanding the Impact of Digital Health Strategies During the COVID-19 Outbreak in Saudi Arabia

BACKGROUND

The impact of COVID-19 has been analyzed from various aspects on the health care services management, accessibility and delivery of health care services. However, the COVID-19 pandemic has led to disruptions in health care services, which led to the increase in adoption of digital health technologies, mostly arising out of need and necessity.

OBJECTIVE

Focusing on the prevailing situations (increasing reliance on digital health services), this study investigates the impact of digital health technologies from the perspectives of policymakers and citizens.

METHODS

A mixed-methods approach was adopted. Twenty-seven semi-structured online interviews were conducted with experts and policymakers for assessing the impact from policymakers' perspectives. An online survey questionnaire instrument was used to collect the responses from 1698 Saudi Arabian citizens in relation to the various aspects of digital health applications.

RESULTS

Health care expenditures increased during the COVID-19 outbreak, resulting in launch of various digital health applications. While policymakers defended their stand in improving health care services and accessibility; citizens reflected inability to book medicines/personal medical equipment online (Mean=2.4) and suffered a lack of personalized care (Mean=2.9) through digital health applications. Moreover, disparities exist between the population groups with respect to the accessibility, utilization, and perceptions of digital health technologies.

CONCLUSION

Policymakers have to consider and address these differences in formulating digital health policies and implementing them.

Beyond building back better: imagining a future for human and planetary health

COVID-19 is disrupting and transforming the world. We argue that transformations catalysed by this pandemic should be used to improve human and planetary health and wellbeing. This paradigm shift requires decision makers and policy makers to go beyond building back better, by nesting the economic domain of sustainable development within social and environmental domains. Drawing on the engage, assess, align, accelerate, and account (E4As) approach to implementing the 2030 Agenda for Sustainable Development, we explore the implications of this kind of radical transformative change, focusing particularly on the role of the health sector. We conclude that a recovery and transition from the COVID-19 pandemic that delivers the future humanity wants and needs requires more than a technical understanding of the transformation at hand. It also requires commitment and courage from leaders and policy makers to challenge dominant constructs and to work towards a truly thriving, equitable, and sustainable future to create a world where economic development is not an end goal itself, but a means to secure the health and wellbeing of people and the planet.

The Sociotechnical Ethics of Digital Health: A Critique and Extension of Approaches From Bioethics

The widespread adoption of digital technologies raises important ethical issues in health care and public health. In our view, understanding these ethical issues demands a perspective that looks beyond the technology itself to include the sociotechnical system in which it is situated. In this sense, a sociotechnical system refers to the broader collection of material devices, interpersonal relationships, organizational policies, corporate contracts, and government regulations that shape the ways in which digital health technologies are adopted and used. Bioethical approaches to the assessment of digital health technologies are typically confined to ethical issues raised by features of the technology itself. We suggest that an ethical perspective confined to functions of the technology is insufficient to assess the broader impact of the adoption of technologies on the care environment and the broader health-related ecosystem of which it is a part. In this paper we review existing approaches to the bioethics of digital health, and draw on concepts from design ethics and science & technology studies (STS) to critique a narrow view of the bioethics of digital health. We then describe the sociotechnical system produced by digital health technologies when adopted in health care environments, and outline the various considerations that demand attention for a comprehensive ethical analysis of digital health technologies in this broad perspective. We conclude by outlining the importance of social justice for ethical analysis from a sociotechnical perspective.

Equitable data sharing in epidemics and pandemics

BACKGROUND

Rapid data sharing can maximize the utility of data. In epidemics and pandemics like Zika, Ebola, and COVID-19, the case for such practices seems especially urgent and warranted. Yet rapidly sharing data widely has previously generated significant concerns related to equity. The continued lack of understanding and guidance on equitable data sharing raises the following questions: Should data sharing in epidemics and pandemics primarily advance utility, or should it advance equity as well? If so, what norms comprise equitable data sharing in epidemics and pandemics? Do these norms address the equity-related concerns raised by researchers, data providers, and other stakeholders? What tensions must be balanced between equity and other values?

METHODS

To explore these questions, we undertook a systematic scoping review of the literature on data sharing in epidemics and pandemics and thematically analyzed identified literature for its discussion of ethical values, norms, concerns, and tensions, with a particular (but not exclusive) emphasis on equity. We wanted to both understand how equity in data sharing is being conceptualized and draw out other important values and norms for data sharing in epidemics and pandemics.

RESULTS

We found that values of utility, equity, solidarity, and reciprocity were described, and we report their associated norms, including researcher recognition; rapid, real-time sharing; capacity development; and fair benefits to data generators, data providers, and source countries. The value of utility and its associated norms were discussed substantially more than others. Tensions between utility norms (e.g., rapid, real-time sharing) and equity norms (e.g., researcher recognition, equitable access) were raised.

CONCLUSIONS

This study found support for equity being advanced by data sharing in epidemics and pandemics. However, norms for equitable data sharing in epidemics and pandemics require further development, particularly in relation to power sharing and participatory approaches prioritizing inclusion. Addressing structural inequities in the wider global health landscape is also needed to achieve equitable data sharing in epidemics and pandemics.

Thanatechnology and the Living Dead: New Concepts in Digital Transformation and Human-Computer Interaction

In a digital society, shall we be the authors of our own experience, not only during our lifetime but also after we die? We ask this question because dying and bereavement have become even harder, and much less private, in the digital age. New big data-driven digital industries and technologies are on the rise, with promises of interactive 3D avatars and storage of digital memories of the deceased, so they can continue to exist online as the "living dead" in a digital afterlife. Famous rock and roll icons like Roy Orbison, Frank Zappa, Ronnie James Dio, and Amy Winehouse have famously been turned into holograms that can once again give "live" performances on the touring circuit, often pulling in large audiences. Death studies, dying, and grief have become virtual in the 21st century. We live in truly unprecedented times for human-computer interactions. Thanatology is the scientific study of death, dying, loss, and grief. In contrast to the biological study of biological aging (cellular senescence) and programmed cell death (apoptosis), thanatology employs multiple professional lenses, medical, psychological, physical, spiritual, ethical, descriptive, and normative. In 1997, Carla Sofka introduced the term thanatechnology as "technological mechanisms such as interactive videodiscs and computer programs that are used to access information or aid in learning about thanatology topics." Onward to 2021, the advent of social media, the Internet of Things, and sensors that digitize and archive nearly every human movement and experience are taking thanatechnology, and by extension, digital transformation, to new heights. For example, what happens to digital remains of persons once they cease to exist physically? This article offers a critical study and snapshot of this nascent field, and the "un-disciplinary" sociotechnical issues digital thanatechnologies raise in relation to big data. We also discuss how best to critically govern this new frontier in systems science and the digital society. We suggest that new policy narratives such as (1) the right to nonparticipation in relation to information and communication technologies and (2) the planetary public goods deserve further attention to democratize thanatechnology and big data. To the extent that systems science often depends on data from online platforms, for example, in times of pandemics and ecological crises, "critical thanatechnology studies," introduced in this article, is a timely and essential field of scholarship with broad importance for systems science and planetary health.

A research and policy agenda for the post-pandemic world

The COVID-19 pandemic response has engaged the academic, public, private and health sectors in the real-time development of technologies and practices to enable predictive, preventive, personalised and participatory (P4) health. Myriad cases of collaborative innovation across these sectors have emerged throughout the pandemic response (despite certain observed technical, social and institutional barriers) that serve as examples to address post-pandemic health system challenges. In this paper, we propose a joint research and policy agenda to generate the knowledge and practices to identify and extend these acute gains toward chronic health system challenges in the post-pandemic era. We identify three key themes for post-pandemic research and policy: the dialectic between novel and traditional techniques, the tension between centralised and local decision-making, and cooperation across academic disciplines, sectors and borders. Going forward, attention to these three themes by researchers and policymakers will help align our health, policy, academic and technological systems to provide better health for all.

Integrating Digital Technologies and Public Health to Fight Covid-19 Pandemic: Key Technologies, Applications, Challenges and Outlook of Digital Healthcare

Integration of digital technologies and public health (or digital healthcare) helps us to fight the Coronavirus Disease 2019 (COVID-19) pandemic, which is the biggest public health crisis humanity has faced since the 1918 Influenza Pandemic. In order to better understand the digital healthcare, this work conducted a systematic and comprehensive review of digital healthcare, with the purpose of helping us combat the COVID-19 pandemic. This paper covers the background information and research overview of digital healthcare, summarizes its applications and challenges in the COVID-19 pandemic, and finally puts forward the prospects of digital healthcare. First, main concepts, key development processes, and common application scenarios of integrating digital technologies and digital healthcare were offered in the part of background information. Second, the bibliometric techniques were used to analyze the research output, geographic distribution, discipline distribution, collaboration network, and hot topics of digital healthcare before and after COVID-19 pandemic. We found that the COVID-19 pandemic has greatly accelerated research on the integration of digital technologies and healthcare. Third, application cases of China, EU and U.S using digital technologies to fight the COVID-19 pandemic were collected and analyzed. Among these digital technologies, big data, artificial intelligence, cloud computing, 5G are most effective weapons to combat the COVID-19 pandemic. Applications cases show that these technologies play an irreplaceable role in controlling the spread of the COVID-19. By comparing the application cases in these three regions, we contend that the key to China's success in avoiding the second wave of COVID-19 pandemic is to integrate digital technologies and public health on a large scale without hesitation. Fourth, the application challenges of digital technologies in the public health field are summarized. These challenges mainly come from four aspects: data delays, data fragmentation, privacy security, and data security vulnerabilities. Finally, this study provides the future application prospects of digital healthcare. In addition, we also provide policy recommendations for other countries that use digital technology to combat COVID-19.

Assessment of COVID-19 control strategies in a steel industry using a SWOT matrix

According to the health regulations, industrial environments due to the gathering of people are considered as one of the highest-risk places during the COVID-19 pandemic. Thus, planning with regard to health concerns can decisively help in infection control and continuity of businesses during the pandemic. The aim of this study was to evaluate the COVID-19 control management measures in the Sepid-farab Kavir Steel Complex (SKS complex) located in Isfahan province (Iran) using strengths, weaknesses, opportunities, and threats (SWOT) matrix. After a literature review and field surveys, all weak, strong, threatening, and opportunity points were collected and were listed using the internal factor evaluation (IFE) and external factor evaluation (EFE) matrices and then were prioritized and weighted. Next, given the sum of scores of IFE and EFE, the SWOT matrix was constructed, the disease prevention and control strategies in the complex was determined, and finally, experts proposed corrective measures to improve the current situation. The results of the IFE matrix (IFE) analysis showed that in terms of corona control, there are more weaknesses than strengths within the company (the score of this matrix was 201.12). Also the score of 165 on the EFE matrix indicated that external threats were predominant, compared to external opportunities of company. SWOT analysis showed that despite some external problems and challenges, the existence of a favorable internal decision-making system had an important role in developing appropriate health strategies and implementing effective prevention measures in SKS complex against the COVID-19.

Harnessing artificial intelligence in cardiac rehabilitation, a systematic review

Aim: This systematic review aims to evaluate the current body of research surrounding the efficacy of artificial intelligence (AI) in cardiac rehabilitation. Presently, AI can be incorporated into personal devices such as smart watches and smartphones, in diagnostic and home monitoring devices, as well as in certain inpatient care settings. Materials & methods: The PRISMA guidelines were followed in this review. Inclusion and exclusion criteria were set using the Population, Intervention, Comparison and Outcomes (PICO) tool. Results: Eight studies meeting the inclusion criteria were found. Conclusion: Incorporation of AI into healthcare, cardiac rehabilitation delivery, and monitoring holds great potential for early detection of cardiac events, allowing for home-based monitoring, and improved clinician decision making.

Digital Is Political: Why We Need a Feminist Conceptual Lens on Determinants of Digital Health

Digital health is a rapidly emerging field that offers several promising potentials: health care delivery remotely, in urban and rural areas, in any time zone, and in times of pandemics and ecological crises. Digital health encompasses electronic health, computing science, big data, artificial intelligence, and the Internet of Things, to name but a few technical components. Digital health is part of a vision for systems medicine. The advances in digital health have been, however, uneven and highly variable across communities, countries, medical specialties, and societal contexts. This article critically examines the determinants of digital health (DDH). DDH describes and critically responds to inequities and differences in digital health theory and practice across people, places, spaces, and time. DDH is not limited to studying variability in design and access to digital technologies. DDH is situated within a larger context of the political determinants of health. Hence, this article presents an analysis of DDH, as seen through political science, and the feminist studies of technology and society. A feminist lens would strengthen systems-driven, historically and critically informed governance for DDH. This would be a timely antidote against unchecked destructive/extractive governance narratives (e.g., technocracy and patriarchy) that produce and reproduce the health inequities. Moreover, feminist framing of DDH can help cultivate epistemic competence to detect and reject false equivalences in how we understand the emerging digital world(s). False equivalence, very common in the current pandemic and post-truth era, is a type of flawed reasoning in decision-making where equal weight is given to arguments with concrete material evidence, and those that are conjecture, untrue, or unjust. A feminist conceptual lens on DDH would help remedy what I refer to in this article as "the normative deficits" in science and technology policy that became endemic with the rise of neoliberal governance since the 1980s in particular. In this context, it is helpful to recall the feminist writer Ursula K. Le Guin. Le Guin posed "what if?" questions, to break free from oppressive narratives such as patriarchy and re-imagine technology futures. It is time to envision an emancipated, equitable, and more democratic world by asking "what if we lived in a feminist world?" That would be truly awesome, for everyone, women and men, children, youth, and future generations, to steer digital technologies and the new field of DDH toward broadly relevant, ethical, experiential, democratic, and socially responsive health outcomes.

Application of IoT in Healthcare: Keys to Implementation of the Sustainable Development Goals

We live in complex times in the health, social, political, and energy spheres, and we must be aware of and implement new trends in intelligent social health systems powered by the Internet of Things (IoT). Sustainable development, energy efficiency, and public health are interrelated parameters that can transform a system or an environment for the benefit of people and the planet. The integration of sensors and smart devices should promote energy efficiency and ensure that sustainable development goals are met. This work is carried out according to a mixed approach, with a literature review and an analysis of the impact of the Sustainable Development Goals on the applications of the Internet of Things and smart systems. In the analysis of results, the following questions are answered about these systems and applications: (a) Are IoT applications key to the improvement of people’s health and the environment? (b) Are there research and case studies implemented in cities or territories that demonstrate the effectiveness of IoT applications and their benefits to public health? (c) What sustainable development indicators and objectives can be assessed in the applications and projects analyzed?

Collaboration Network and Trends of Global Coronavirus Disease Research: A Scientometric Analysis

As a global pandemic threatens health and livelihoods, finding effective treatments has become a vital issue that requires worldwide collaboration. This study examines research collaboration and network profiles through a case study of coronavirus diseases, including both the extinct severe acute respiratory syndrome coronavirus (SARS-CoV) and the emerging species (SARS-CoV-2). A scientometric process was designed to apply quantitative tools and a qualitative approach employing technological expertise to accomplish a three-level collaboration analysis. The text mining software, VantagePoint, was used to analyze research articles from the Web of Science database to identify the key national, organizational, and individual players in the coronavirus research field combined with indicators, namely, the breadth and depth of collaboration. The results show that China and the United States are at the center of coronavirus research networks at all three levels, including many endeavors involving single or joint entities. This study demonstrates how governments, public sectors, and private sectors, such as the pharmaceutical industry, can use scientometric analysis to gain insight into the holistic research trends and networks of players in this field, leading to the formulation of strategies to strengthen research and development programs. Furthermore, this approach can be utilized as a visualization and decision support tool for further policy planning, identification and execution of collaboration, and research exchange opportunities. This scientometric process should be directly applicable to other fields.

Digital Health Solutions to Control the COVID-19 Pandemic in Countries With High Disease Prevalence: Literature Review

BACKGROUND

COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, has become a global pandemic, affecting most countries worldwide. Digital health information technologies can be applied in three aspects, namely digital patients, digital devices, and digital clinics, and could be useful in fighting the COVID-19 pandemic.

OBJECTIVE

Recent reviews have examined the role of digital health in controlling COVID-19 to identify the potential of digital health interventions to fight the disease. However, this study aims to review and analyze the digital technology that is being applied to control the COVID-19 pandemic in the 10 countries with the highest prevalence of the disease.

METHODS

For this review, the Google Scholar, PubMed, Web of Science, and Scopus databases were searched in August 2020 to retrieve publications from December 2019 to March 15, 2020. Furthermore, the Google search engine was used to identify additional applications of digital health for COVID-19 pandemic control.

RESULTS

We included 32 papers in this review that reported 37 digital health applications for COVID-19 control. The most common digital health projects to address COVID-19 were telemedicine visits (11/37, 30%). Digital learning packages for informing people about the disease, geographic information systems and quick response code applications for real-time case tracking, and cloud- or mobile-based systems for self-care and patient tracking were in the second rank of digital tool applications (all 7/37, 19%). The projects were deployed in various European countries and in the United States, Australia, and China.

CONCLUSIONS

Considering the potential of available information technologies worldwide in the 21st century, particularly in developed countries, it appears that more digital health products with a higher level of intelligence capability remain to be applied for the management of pandemics and health-related crises.

Primary and Secondary Students’ Usage of Digital Platforms for Mathematics Learning during the COVID-19 Outbreak: The Case of the Gaza Strip

During the outbreak of the COVID-19 pandemic, digital learning has reshaped mathematics education in different ways. In particular, different social media platforms have acquired an unforeseen prominence as a way to enhance mathematics learning and to model somehow the face-to-face classroom interactions abruptly interrupted. How primary and secondary students have reacted or responded to these changes in the initial learning conditions is the main aim of this study. With this purpose in mind data was collected from 3179 students from the Gaza Strip by means of a validated rating scale and then a cluster analysis approach was applied that revealed the existence of three clusters. K-means cluster analysis was applied to analyze data as an exploratory approach to identify structures within the data. Also, chi-square was applied to identify differences between the clusters with regard to demographic characteristics. Regarding the grouping of participants in clusters the analysis performed lead to the identification of three clusters: Cluster 1, 2 and 3 had 2001, 824 and 354 cases, respectively. These clusters were grouped depending on employ social media platforms used by the students to reinforcement their mathematics learning. Participants in Cluster 3 exhibited the highest proficiency in the usage of social media for mathematics learning as compared to those in Cluster 1 and Cluster 2. This means that students in cluster 1 are more likely to exhibit negative attitudes and low levels in the skills related to using digital technology and the employment of social media in mathematics learning. The results showed that there were no significant differences between cluster-groups with regard to gender, age, and type of school. In contrast, significant differences were found among the three clusters with regards to the educational level of parents and the economic status of the family. However, the overall results show that digital learning is considered a positive response to the school closure in the time of the COVID-19 outbreak.

Artificial Intelligence and technology in COVID Era: A narrative review

Application of artificial intelligence (AI) in the medical field during the coronavirus disease 2019 (COVID-19) era is being explored further due to its beneficial aspects such as self-reported data analysis, X-ray interpretation, computed tomography (CT) image recognition, and patient management. This narrative review article included published articles from MEDLINE/PubMed, Google Scholar and National Informatics Center egov mobile apps. The database was searched for "Artificial intelligence" and "COVID-19" and "respiratory care unit" written in the English language during a period of one year 2019-2020. The relevance of AI for patients is in hands of people with digital health tools, Aarogya setu app and Smartphone technology. AI shows about 95% accuracy in detecting COVID-19-specific chest findings. Robots with AI are being used for patient assessment and drug delivery to patients to avoid the spread of infection. The pandemic outbreak has replaced the classroom method of teaching with the online execution of teaching practices and simulators. AI algorithms have been used to develop major organ tissue characterization and intelligent pain management techniques for patients. The Blue-dot AI-based algorithm helps in providing early warning signs. The AI model automatically identifies a patient in respiratory distress based on face detection, face recognition, facial action unit detection, expression recognition, posture, extremity movement analysis, visitation frequency detection sound pressure, and light level detection. There is now no looking back as AI and machine learning are to stay in the field of training, teaching, patient care, and research in the future.

Higher Acceptance of Videotelephonic Counseling Formats in Psychosomatic Medicine in Times of the COVID-19 Pandemic

Background: Due to the COVID-19 pandemic, the healthcare system in general and psychosomatics in particular were forced to change counseling-specific services and break up established structures. At the beginning of 2020, phone as well as videotelephonic counseling options had to be quickly established. Methods: Patients (n = 278) of the department of psychosomatic medicine and psychotherapy at the University Hospital Tübingen were asked to complete an ad hoc questionnaire to assess the acceptance of the counseling format following each counseling session (office, phone, video) in the period between July 2020 and February 2021. Results: Satisfaction and acceptance of the three counseling formats (office, phone, video) were rated (1-6) on average as "good" to "very good" in the three subgroups (1.5 ± 0.9). Likewise, the "therapeutic relationship" scored high in all three subgroups in terms of establishing a strong therapeutic relationship (4.4 ± 1.5). "Hurdles" were rated as low and tolerable (1.8 ± 1.3). The global assessment of therapeutic contact was significantly better in the video group compared to phone and office consultation (p < 0.05). Predictor analyses showed that there was an influence of age, but not gender, on the acceptance of digital counseling formats in the present sample [F _{(1, 277)} = 4.50, p = 0.04]. Discussion & Conclusion: Digital consultation formats were perceived by patients as promising addition to the classic face-to-face setting. Digital formats (phone, video) were not generally preferred to face-to-face counseling, but especially video counseling was accepted and perceived with great satisfaction and acceptance. Accordingly, the additional use of digital counseling formats, especially video-telephony, could be an opportunity to enrich the existing structures also after the pandemic.

A critical analysis of the impacts of COVID-19 on the global economy and ecosystems and opportunities for circular economy strategies

The World Health Organization declared COVID-19 a global pandemic on the 11th of March 2020, but the world is still reeling from its aftermath. Originating from China, cases quickly spread across the globe, prompting the implementation of stringent measures by world governments in efforts to isolate cases and limit the transmission rate of the virus. These measures have however shattered the core sustaining pillars of the modern world economies as global trade and cooperation succumbed to nationalist focus and competition for scarce supplies. Against this backdrop, this paper presents a critical review of the catalogue of negative and positive impacts of the pandemic and proffers perspectives on how it can be leveraged to steer towards a better, more resilient low-carbon economy. The paper diagnosed the danger of relying on pandemic-driven benefits to achieving sustainable development goals and emphasizes a need for a decisive, fundamental structural change to the dynamics of how we live. It argues for a rethink of the present global economic growth model, shaped by a linear economy system and sustained by profiteering and energy-gulping manufacturing processes, in favour of a more sustainable model recalibrated on circular economy (CE) framework. Building on evidence in support of CE as a vehicle for balancing the complex equation of accomplishing profit with minimal environmental harms, the paper outlines concrete sector-specific recommendations on CE-related solutions as a catalyst for the global economic growth and development in a resilient post-COVID-19 world.

DFC, Medina E, Sinche F, Santiago Vispo N, Dahoumane SA, Alexis F. Biomedical Science to Tackle the COVID-19 Pandemic: Current Status and Future Perspectives

The coronavirus infectious disease (COVID-19) pandemic emerged at the end of 2019, and was caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which has resulted in an unprecedented health and economic crisis worldwide. One key aspect, compared to other recent pandemics, is the level of urgency, which has started a race for finding adequate answers. Solutions for efficient prevention approaches, rapid, reliable, and high throughput diagnostics, monitoring, and safe therapies are needed. Research across the world has been directed to fight against COVID-19. Biomedical science has been presented as a possible area for combating the SARS-CoV-2 virus due to the unique challenges raised by the pandemic, as reported by epidemiologists, immunologists, and medical doctors, including COVID-19's survival, symptoms, protein surface composition, and infection mechanisms. While the current knowledge about the SARS-CoV-2 virus is still limited, various (old and new) biomedical approaches have been developed and tested. Here, we review the current status and future perspectives of biomedical science in the context of COVID-19, including nanotechnology, prevention through vaccine engineering, diagnostic, monitoring, and therapy. This review is aimed at discussing the current impact of biomedical science in healthcare for the management of COVID-19, as well as some challenges to be addressed.